Hemangioma of the liver: causes and treatment, symptoms, complications

Among the multiple benign neoplasms of the liver, the most common are hemangiomas.

Hemangioma is - sammelbegriff( collective term), which includes various types of new-borns of vascular origin, caused by blastomatous and disembrioplastic origin:

• benign form of hemangiendothelioma;
  
• capillary and cavernous formations;
  
• venous and groinlike angiomas.

Characteristics of formations

Forms and condition of hemangiomas are different.

• depends on the very structure of the tumor;
  
• on its dimensions;
  
• the state of vascular caves;
  
• on the degree of their blood content;
  
• presence of thrombosis;
  
• on the nature of the development of mesenchymal tissue( connective).

Quite often, hemangiomatosis is characterized by hemorrhages inside the tumor, provoking the accumulation of fluid in its central part, which often causes cystic neoplasms. This process promotes the development of fibrosis in the central part of the tumor.

The local increase in the sites of tumor tissue regeneration is characteristic, due to the changes in protoplasm and deposits within the tissue of protein substances, the cells of the hemangioma degenerate into a glassy structure with a constant growth of lesions. Old and fresh thrombosis, vitreous degeneration and sclerosis inside the tissues of the hemangioma lead to unpredictable spontaneous ruptures.


The largest tumor was removed in 1898 - more than five kilograms.

According to various sources, as a result of a hundred-year study of the disease, the scientists came to the conclusion that the increase in hemangioma formations is due to hemorrhages, thrombosis within the tumor and pathological expansion of the vascular lacunae walls, and not due to the formation of new cells leading to tissue growth and hypertrophic processes.

Classification of neoplasms

There are multiple versions of the classification of hepatic hemangiomatosis. The most common of them relates hemangiomas to the group of vascular and stromal-vascular( mesenchymal) neoplasms.

According to the clinical picture, hemangiomas of the liver are divided into four forms:

• form of asymptomatic flow;
  
• not complicated forms, but with clinical manifestations;
  
• complicated forms;
  
• atypical forms that occur against the background of concomitant diseases.

The clinical course of hemangiomatosis is often manifested in the combination of cirrhosis, but there is no single version - hemangioma provokes the formation of cirrhosis or vice versa, the development of connective tissue with vascular deformation, gives rise to the formation of tumors of hemangioma.

The histological structure characterizes a hemangioma, as a tumor from multiple cystic wells, which are filled with blood. Fibrous tissue, of different layers, divides cystic wells between each other.

The structure of the hemangioma is completely dependent on the number of wells and fibrous tissue. The liver cells around and under the wells are deformed, located in a chaotic state, or completely absent. The structure of neighboring tissues does not change.

Causes of hemangioma of the liver

Benign tumor tumors affect the liver at any age, both infant and senile. The predominant majority is the female sex.

The most frequent types of damage to the liver include capillary and cavernous appearance of tumor formations.

The capillary view of hemangiomatosis consists of a dense, uniform, fine-meshed structure, resulting from an excess of mutated benign cells that repeat the structure of the vascular wall tissues. They look like multiple small intracavitary reservoirs. A number of capillary vessels located nearby are affected.

The cavernous form of hemangiomas is the formation of a dough-like consistency with a smooth or rough surface, with a multitude of internal cavities separated by bridges. The most dangerous form of neoplasm. Accumulation and overflow in the reservoirs of plasma or intracellular fluid can provoke excessive growth of the tumor, its rupture and hemorrhage into the cavity of the peritoneum.

The etiologic factor, until today, has not been determined. There are only supposed versions based on the research of many scientists. For example:

1. 1) The dispute over whether hemangioma is a tumor or a vascular malformation is not yet resolved. The fact of the manifestation of formations as a result of the genetic and family factor is disputed.
   
2. 2) But, at the same time, the increase in the growth of formations is attributed to the sexual factor, in particular, in women who at least once were pregnant, the tumor occurs more often than those who did not become pregnant. This is associated with an increase in the level of hormones of estrogen, which loads the liver and provokes an increased development of neoplasms.
   
3. 3) We consider the versions of intrauterine development, grounded in the violation of intrauterine formation with the development of dysontogenetic tumors.
   
4. 4) The most common theory relates hemangioma to congenital diseases as a result of viral infections during pregnancy and premature birth, which explains the not completely formed system of blood vessels of the liver. And causal factors in the form of injuries, hormonal disorders and the effects of infections, are only contributing, secondary factors.
   
5. 5) The hepatic venous vessels are considered to be the nutrient medium in the development of hemangiothosis.

Possible complications of

Unsecured tumor formations, even of benign nature, and neglect of the process, lead to various complications of

• ruptured formations and intra-abdominal hemorrhage;
  
• bleeding into the intestines from the biliary tract;
  
• development of cirrhosis and hepatic insufficiency;
  
• jaundice and development of abdominal dropsy;
  
• formation of heart failure;
  
• leads to squeezing and displacement of neighboring organs;
  
• possible degeneration into malignant formation;
  
• thrombosis and inflammatory processes of tumor outgrowths.

Symptoms of a hemangioma of the liver

Signs of a hemangioma of a liver are diverse, in many respects depend on the characteristics of neoplasms - the size, localization, the degree of damage to liver tissues, the manifested complications and many other reasons. Symptoms manifested:

• pain as a result of the infringement;
  
• swelling, with the attachment of bacteria and viruses;
  
• yellowing of the fibrous membrane of the eyeball;
  
• sharp painful manifestations in the right hypochondrium region;
  
• with dark calves and red urine;
  
• by constant intoxication and frequent vomiting;
  
• development of anemia as a result of bleeding.

Treatment of hemangioma of the liver

For the diagnosis confirming the presence of this disease, apply studies of a different orientation:

1. 1) The method of the roentgenogram allows you to see the calcified form of the censule.
   
2. 2) With the help of the ultrasound method, clearly visible formations with clearly defined boundaries.
   
3. 3) Computed tomography with the introduction of contrast agent, allows to detect calcification or thrombi in tumors that usually appear after bleeding.
   
4. 4) The MRI method is indispensable in determining small tumors.
   
5. 5) With the help of single-photon emission computed tomography, formations with a high content of bloody substrate are detected.
   
6. 6) The angiographic method is indicated when CT does not produce results due to the displacement of the hepatic arteries by a large tumor.
   
7. 7) Sight liver biopsy is needed to exclude malignant transformation.

If the clinical picture of the disease does not reflect the increase in clinical symptoms, and neoplasms do not increase in size, the treatment of hemangioma of the liver, as such, is not required. The threat of a rupture is not an indication of the use of cardinal measures.

Surgical intervention, as a method of lobotomy and segmentectomy, is performed only with severe pain or progressive rapid tumor growth.

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